Angel Medical, Mission consider partnership

Angel Medical Center in Franklin may soon come under the wing of Mission Hospital in Asheville.

Smaller, rural hospitals are increasingly forging partnerships with larger hospitals as it becomes tougher financially to go it alone. Angel’s 15-member hospital board unanimously voted to explore an affiliation with Mission for both financial reasons and in hopes of improving health care in the community.

“There is no question there are some financial advantages,” said Angel CEO Tim Hubbs. Particularly when it comes to economies of scale when ordering supplies and negotiating purchase contracts.

“They have more negotiating power than us. We are one-twentieth of their size,” Hubbs said.

Mission brings in more than $1 billion in net patient revenue a year and has 800 doctors that practice there. Angel has 41 physicians and averages about 15 patients staying each night in the hospital

Medical care for people in Macon County could also benefit, Hubbs said. Doctors would have the benefit of consulting with specialists over cases and diagnosis. Ideally, doctors from Mission in more specialized fields would be willing to hold office hours in Franklin certain days of the month, helping patients who now have to travel out of the county. Hubbs said Mission won’t try to compete with established practices in Franklin, and would only make forays into specialties that Macon County doesn’t have the patient base to support.

Last year, Haywood Regional Medical Center joined forces with WestCare hospitals in Sylva and Bryson City. The trio then entered a management contract with Carolinas HealthCare System, a massive conglomerate based in Charlotte with 32 hospitals under its umbrella.

Two years ago, that number was just 22 — showing just how rapidly rural hospitals are affiliating with bigger institutions.

Mission, meanwhile, has partnerships with the hospitals in Spruce Pine and McDowell County. The hospital in Brevard is exploring an affiliation with Mission as well.

Hubbs said the Angel hospital board feels Mission is a better fit than jumping on board with WestCare and Haywood. Hubbs said Angel has a long-standing relationship with Mission already, and Mission has continually broached the subject of an affiliation with Angel over the years.

Mission vied for an affiliation with WestCare and Haywood but was beat out by Carolinas. That makes Angel all the more important strategically for Mission as it aims to transition from its reputation as the go-to regional hospital for advanced procedures to a flagship institution at the head of a regional network.

“I know they would love to see other hospitals in the region join them as well,” Hubbs said. “I think they have to figure out what they can bring to the table.”

Mission was too close for comfort for many Haywood physicians, who felt the proximity makes Mission more of a competitor than potential partner. Franklin physicians could feel the same way toward WestCare. Several medical practices in Sylva have satellite offices in Franklin, capturing patients who are then seen at Harris instead of Angel.

Hubbs said the presence of Sylva-base physicians in Franklin has been mutually beneficial in ways, however.

“WestCare over the years has provided office space over here to give their physicians fuller practices, and we also had some weak spots in terms of physicians in our own community,” Hubbs said.

An affiliation with Mission could take many forms, from an outright sale of the hospital at one end of the spectrum to a management contract on the other. Hubbs envisions something in the middle, with some level of shared ownership yet a measure of local autonomy.

“We wouldn’t want Mission to be able to control all things,” Hubbs said.

Hubbs said Angel Medical Center has lost money the past two years, though he would not share hard numbers. The hospital’s financial statements are private.

The loss is largely due to upfront costs of new equipment and recruiting new doctors, both of which will reap benefits down the road.